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37 Cards in this Set
- Front
- Back
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passive movement of electrolytes and other particles from higher concentration to lower concentration gradient |
diffusion |
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requires ATP (energy) to move electrolytes against concentration gradient into cell membrane |
Active Transport |
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movement of fluids across capillaries |
filtration |
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pulling of water into and out of the cells by osmotic pressure |
osmosis |
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fluids within the cell |
intracellular fluid (ICF) |
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fluid outside of cell membranes |
extracellular fluid |
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3 types of extracellular fluid |
intravascular fluid interstitial fluid transcellular fluid |
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intravascular fluid |
liquid part of blood (plasma) |
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interstitial fluid |
located between cells, and outside of blood vessels |
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transcellular body fluids |
secreted by epithelial cells (cerebrospinal, pleural, peritoneal and synovial fluids) |
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causes of fluid imbalances |
vomiting diarrhea nasogastric suction diaphoresis diuretic therapy diabetes insipidus kidney disease adrenal insufficiency osmotic diuresis peritonitis intestine obstruction ascities burns hemorrhage NPO |
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osmolality imbalances occur |
when there's a disturbance in concentration of body fluid |
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osmolality imbalances occur when body fluids become either |
hypertonic or hypotonic |
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examples of osmolality imbalances |
hypernatremia (water defect) hyponatremia (water excess) |
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volume imbalances occur when |
too little or too much isotonic fluid is present |
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risk factors for Fluid Volume Defect (hypovolemia) |
Strenuous exercise ⬆️intake of alcohol or caffeine living in high elevations and dry climates
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why are older adults at greater risk of fluid imbalances? |
⬇️skin elasticity ⬇️GFR of kidneys ⬇️concentration ability of kidneys ⬇️muscle mass diminished thirst reflex
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expected findings of hypovolemia |
hyperthermia, tachycardia (in attempt to maintain normal bp), thready pulse, hypotension, orthostatic hypotension, ⬇️Central venous pressure, tachypenea (to compensate for lack of fluid volume w/in body), hypoxia, dizziness, syncope, confusion, weakness, fatigue, thirst, dry furrowed tongue, nausea, vomiting, anorexia, acute weight loss, olguria, ⬇️cap refill, cool clammy skin, poor skin turgor, flattened neck veins |
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hypernatremia |
extreme thirst skin dry and flushed orthostatic hypotension restless confusion agitation coma and seizures can occur |
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lab tests for Fluid Volume Defect |
Hct = ⬆️ BUN=⬆️(>25 mg/dL) due to hemoconcentration Urine specific gravity = >1.030 Serum sodium = >145 mEq/L Serum osmolality= > 295 mOsm/kg |
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complications of hypovolemia |
hypovolemic shock |
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hypovolemic shock |
occurs with significant loss of body fluid |
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nursing interventions for hypovolemic shock |
give O2 and monitor O2 sat (anything <70% is emergency) stay w/ patient monitor vitals every 15 minutes provide replacement blood and isotonic fluid administer vasoconstrictors preform hemodynamic monitoring |
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vasoconstrictors to administer |
dopamine norepinephrine phenylephrine |
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agents to administer to improve myocardial perfusion |
sodium nitroprusside |
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positive inotropic medications |
dobutamine milrinone |
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fluid overload may occur when |
electrolytes in body are not in balance |
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complications of fluid volume excess |
pulmonary edema congestive heart failure |
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risk factors for hypervolemia |
heart failure kidney disease cirrhosis OD of Na concentrated fluids fluid shifts following burns prolonged corticosteroid use severe stress hyperaldosteronism |
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expected findings of fluid volume overload |
tachycardia bounding pulse hypertension tachypenea ⬆️central venous pressure weak due to retained fluid headache altered LOC ascities crackles cough ⬆️RR dyspnea peripheral edema weight gain distended neck veins ⬆️ urine output |
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labs for hypervolemia |
⬇️Hct ⬇️urine & serum osmolarity ⬇️urine Na and specific gravity ⬇️BUN due to plasma dilution |
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manifestations of pulmonary edema |
anxiety, tachycardia, ⬆️dyspnea at rest, change in LOC, restlessness, lethargy, crackles, pink frothy sputum with productive cough |
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ability of all solutes to cause osmotic driving force that promotes water movement from one compartment to another |
tonicity |
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concentration of fluid that affects movement of water between fluid compartments by osmosis |
osmolality |
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serum osmolality primarily reflects |
concentration of sodium |
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urine osmolality is determined by |
urea, creatine, and uric acid |
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most reliable indicator of the concentrating ability of kidneys |
urine osmolality |
